Activity 3.1.2: Sickle Cell Diaries
Introduction
When Anna Garcia was 14 months old, she was admitted to the hospital with a
variety of serious symptoms. Anna’s parents were very scared and were not sure
what was happening with their daughter. Ultimately, this hospital trip led to her
diagnosis of sickle cell anemia. Sickle cell anemia is an inherited disorder affecting
millions of people around the world. Almost all patients with the disease experience
painful episodes, known as crises, like the first one Anna had as a baby.
Living with sickle cell anemia can often be difficult, especially for children. Patients
dealing with the disease have to alter their lifestyle in order to avoid anything that
may cause a crisis, such as certain medications, high altitudes, and strenuous
exercise. They are often fatigued due to chronic anemia and have a high rate of
infection. In this activity you will learn about what it is like for a person dealing with
this serious disease. You will review Anna Garcia’s medical records to learn more
about her diagnosis. You will read her diary entries, which will detail what life was
like for her living with sickle cell anemia. You will then be assigned a fictitious patient
who is undergoing a treatment for sickle cell disease. You will write diary entries for
your assigned patient detailing how they are feeling and a description of the
treatment they are receiving, including the risks and benefits. You will also include a
narrative of all of the biomedical professions the patient encounters during their
treatment journey.
Equipment
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Computer with Internet access
Laboratory journal
PBS Course File
Activity 3.1.2 Medical History Resource Sheet
Activity 3.1.2 Diary Entries Resource Sheet
Career journal
Career Journal Guidelines
BEFORE STARTING:
1. Note that sickle cell disease is a blood disorder. Therefore, it is important to
understand the components and functions of healthy blood in order to
understand the disease.
2. Use reliable Internet sources to research the function of the following
components of blood: plasma, red blood cells (also called erythrocytes), white
blood cells (also called leukocytes), and platelets (also called thrombocytes).
Record your findings in the table below. Include a 1-2 sentence description of
function for each.
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Principles of Biomedical Science Activity 3.1.2 Sickle Cell Diaries – Page 1
Component:
Function:
Plasma
Blood plasma is the watery, liquid
component of blood.
Red Blood Cells (Erythrocytes)
Hemoglobin is the protein inside red
blood cells that carries oxygen. Red
blood cells also remove carbon dioxide
from your body, transporting it to the
lungs for you to exhale.
White Blood Cells (Leukocytes)
Some white cells travel throughout the
body and destroy bacteria, some
produce antibodies against bacteria and
viruses, and others help fight malignant
diseases.
Platelets (Thrombocytes)
The principal function of platelets is to
prevent bleeding. Red blood cells are
the most numerous blood cells, about
5,000,000 per microliter.
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Find on the Internet images of a healthy red blood cell and sickle cell and
copy and paste it below:
Conclusion
1. You fall down and scrape your hand – describe what each component of blood
would be doing at the injury site.
First the plasma would start to fall out along with the blood. Then
over time as the blood stops that’s the platelets in action to stop
the bleeding.
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2. Anna has a condition called sickle cell anemia, a blood disorder. Based on the
differences you observed between the normal blood slide and Anna’s blood slide,
what do you think is a defining feature of this disease? Explain your answer.
From the slide I believe that a feature would be how the blood
works in the body. I say this because when you have this disease
the bodies
3. How does the abnormal shape of a sickled red blood cell affect its movement
through blood vessels?
It makes the blood clump together stopping the blood flow.
4. People with sickle cell anemia often experience episodes of severe pain in their
joints, chest, and abdomen and swelling in their hands and feet. Using what you
know about the function of blood, why do you think the abnormal shape of sickled
red blood cells causes these symptoms?
This is because when the blood stops flowing to one place that
place or area gets damaged and or effected and begins to hurt.
5. Anna’s autopsy shows that the nails on her fingers were a blue/gray color. How
does Anna’s hematocrit level relate to these symptoms?
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Her arteries were clogged stopping the oxygen flow causing her
nails to turn into that color.
6. How might sickle cell disease have been related to Anna’s death?
This could be because the blood in her body might have stop
flowing to a vital organ causing her death.
Procedure
7. Obtain an Activity 3.1.2 Medical History Resource Sheet from your teacher.
8. Read through this piece of Anna’s medical history.
9. Answer Conclusion question 1.
Almost every patient with sickle cell anemia experiences painful episodes called crises.
These crises can last anywhere from a couple of hours to several days. The piece of
Anna Garcia’s medical history that you just read is the documentation of Anna’s first
sickle cell crisis. These crises vary from person to person. Some patients experience an
episode only once every few years, while others experience many episodes per year.
The crises can be severe enough to require a hospital stay. As part of Anna’s long term
treatment plan, Anna’s doctor asked her to keep a diary documenting all of her crises.
10. Obtain a Activity 3.1.2 Diary Entries Resource Sheet from your teacher.
11. Make a graphic organizer that includes the following categories: symptoms,
benefits associated with treatment, risks associated with treatment, biomedical
professionals involved, and lifestyle concerns.
12. Read through the four diary entries and highlight or underline important
information. As you read, take notes in the appropriate categories of your graphic
organizer.
13. Answer Conclusion questions 2 and 3.
14. Add any new ideas to the Possible Causes of Death section on the Activity 3.1.1
Autopsy Report.
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15. File the Activity 3.1.2 Medical History Resource Sheet and the Activity 3.1.2 Diary
Entries Resource Sheet in the appropriate tabs of your course file. Use the PBS
Course File – Table of Contents as a guide.
16. Note that your teacher will assign you one of the following sickle cell anemia
patients:
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4 year old male being treated with antibiotics and folic acid supplements
7 year old female being treated with chronic transfusion therapy
15 year old male who will have a bone marrow transplant
17. Write two journal entries from the perspective of your assigned patient or from
the perspective of the patient’s parents. Include the following information in your
journal entries:
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The symptoms the patient is experiencing and how this is affecting daily
life.
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An explanation of what the treatment entails, including the risks and
benefits
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A description of at least two of the biomedical professionals working with
the patient. One of the biomedical professionals must be a hematologist.
The description must detail the role the professionals played in the
patient’s case. Note that you will complete career journal entries for these
two professionals later in this activity.
18. Answer Conclusion question 4.
19. Collaborate with two classmates who were assigned other patients. Share your
journal entries with these classmates. Create a graphic organizer similar to the
one you created in Step 5 and take notes as they share their journal entries with
you.
20. Follow the Career Journal Guidelines and complete two entries in your Career
Journal for the two careers included in your patient journal entries.
21. Follow the PLTW Biomedical Science Documentation Protocol to correctly
document or cite the sources of information you used.
22. Update the classroom evidence board with information from Lesson 3.1.
23. Answer the remaining Conclusion questions.
Conclusion
24. Based on what you know about blood, why would having a sickle cell anemia
crisis result in a reduced red blood cell count, an elevated white blood cell count,
and a reduced hematocrit?
The red blood cells reduce because they change shape into a crescent
shape. The white blood cells go to the scene of the crime to try to fix
everything so more are needed. A low hematocrit means the
percentage of red blood cells is below the lower limits of normal
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25. Based on what you learned in the previous activity, why did having sickled red
blood cells lead to the symptoms documented in Anna’s medical history when
she was 14 months old?
The clogged blood streams led to insufficient blood flow causing
her to have experienced what she did.
26. Describe three ways daily life is affected for those who have sickle cell anemia.
One way is that, that person can undergo varies symptoms.
Another way is that that person would have to get blood
transfusions a lot. The third way would be that this person would
spent a lot of time resting to recover from what they have to deal
with forever.
27. Describe at least five symptoms of a sickle cell crisis.
Dehydration, fever, bleeding, cold exposure, and hypoxia.
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28. Describe the pros and cons of the treatments used for each of the sickle cell
anemia patients investigated in this activity.
A pro could be that your body is being helped and you would have
to suffer as much. A con would be that your body gets drugged
up.
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